In the state of the art, the name arthrosis is meant as a chronic degenerative arthropathy which primarily affects the articular cartilage and secondly the bone, synovial and capsular component. The progressive rise in the average age of the population and the evolving and disabling character of the disease have together contributed to make arthrosis one of the most frequent diseases, with the greatest impact on society.
To be more exact, due to the continuous stresses to which they are subject, the joints are frequently subject to arthrosis. Arthrosis of the hip, or coxarthrosis, can also be caused by congenital and acquired deformities. Arthrosis causes pain in the region of the joint, for example in the hip, which characteristically refers to the level of the groin, radiates to the thigh, and is alleviated with rest. Hereafter, we shall describe the case of the hip joint, but the description can equally well be transferred to other cases of possible application according to the invention.
Sometimes the symptomatology of arthrosis of the hip can be manifested with a painful contracture of some muscles in the thigh. The functional limitation of coxarthrosis is of considerable importance given the importance this joint has in the actions of everyday life.
In the last twenty years, the surgical treatment of coxarthrosis has had a rapid and substantial evolution, with the introduction of total arthro-prosthesis of the hip. The immediate results obtained, compared with previous techniques, for example Voss's operation, or osteotomy of the femur and/or pelvis, have caused a new and—for many people—definitive course in the treatment of coxarthrosis.
In fact, before the arrival of arthro-prostheses, one of the operations most commonly practised, as proposed by Voss in 1952, included the surgical lysis of the most important periarticular muscles of the hip contractured in the course of the coxarthrosis, thus achieving the purpose of interrupting, in an efficient and enduring manner, the vicious circle created by the combination of pain-contracture and contracture-pain.
In practice, the operation proposed by Voss consisted in sectioning several groups of muscles which make up the muscular funnel of the hip; this sectioning caused, with immediate effect, a recovery in the travel of the hip and, when the patient awoke, the pain disappeared more or less completely. However, given the traumatic and detrimental nature of the operation, the introduction of a hip arthro-prosthesis has progressively replaced this practice and in recent years has been affirmed as the most efficient technique for restoring a damaged or degenerated joint.
However, even adopting the arthro-prosthesis has not completely solved the problem connected with coxarthrosis, especially considering the fact that prostheses used at present have an average duration of not more than 10–15 years, which means often the requirement of an operation to remove the old prosthesis and put a new one in. Such operations are often very complicated, especially when there is a clinical condition which is already problematic, for example in very elderly people. It is therefore necessary to delay as long as possible the fitting of any hip prosthesis, and yet at the same time to ensure that, while waiting for the operation, the patient can enjoy a high quality of life, absence of pain and efficient articulation.
Epicondylitis, instead, is an insertional tendinopathy with an acute or chronic course, which affects the proximal tendinous insertion of the muscles with an epicondyloid origin (the anconeus, the common extensor muscle of the fingers, extensor muscle of the little finger, the ulnar extensor of the wrist).
The causes of this condition are functional stresses and repeated traumas.
The symptomology is characterized by pain in the insertion seat of the tendon at the epicondyle.
The conservative therapeutic treatment consists of local infiltrations of painkillers or cortisone; when the infiltration therapy does not solve the symptoms of pain, a surgical treatment is normally started which consists of partly detaching the epicondyle muscles in order to reduce the tension in the tendinous insertion seat of the muscles involved.
On the contrary, rotator muscle cap pathology means the whole pathology, painful but not traumatic, of the periarticular structures of the shoulder. Most of these syndromes mainly refer to a tendinosis of the extrarotator muscles of the shoulder, and particularly to tendinosis of the supraspinal in the section below the acromion-clavicular arch; however it can involve the other extrarotator muscles (infraspinal, subspinal and teres minor).
The rotator muscle cap pathology is a tendinopathy which tends to occur in subjects who are over forty, or in young people who practised sports which entail a great effort in the upper limb.
The symptomology is differentiated: acute and chronic. Acute symptomology is usually the consequence of an effort and is accompanied by a serious functional limitation of the scapular-humeral joint.
The chronic form is characterized by recidivous forms of pain, it tends to become more accentuated both with abduction and with intra-extrarotation and can be referred to the friction produced; for this reason it is also called “impingement syndrome”.
The treatment does not require a surgical operation in the acute forms and in its first approach to the chronic forms; it consists of local infiltration of cortisones and anaesthetics, followed by intense physio-kinesitherapy, both active and passive.
In friction syndromes it is appropriate to section off the coraco-acromial ligament with removal of the bursa and acromionplastic.
All the pathologies indicated above have in common the presence of a muscular tension which leads some contracted muscles to exert a pressure on the relative joint (hip, elbow, shoulder), accentuating the feeling of pain and causing a rapid degeneration of the phenomena of arthrosis of the joint itself.
At present, as we said, these pathologies are resolved mainly through surgery, by sectioning the muscles, or by intervening with prostheses or similar, or with the other treatments we have indicated.
The present Applicant has devised and embodied this invention to overcome the shortcomings of current techniques, and to obtain further advantages as explained hereafter.